Predictors of successful molecularly targeted therapy based on comprehensive genomic profiling data

Aim – to study predictors of successful performance of comprehensive genomic profiling and prescription of molecular targeted therapy for patients with advanced solid tumors.

Material and methods. We performed a retrospective single-center study of data of 104 patients who underwent comprehensive genomic profiling by targeted sequencing in the period of 2019 to 2023. The assessment of clinical significance of the identified genome alterations was performed using the scale for clinical actionability of molecular targets of the European Society for Medical Oncology (ESCAT). Analysis were performed of the mutation spectrum, efficiency of molecular targeted therapy, and its effect on survivability. Methods of logistical regression were used for the statistical analysis.

Results. Comprehensive genomic profiling was successfully performed in 87 patients (83.7%). Potentially targeted alterations were found in 44.8% patients, of which 11 persons received molecular targeted therapy. The main predictors of successful performance of comprehensive genomic profiling were the sufficient volume of tumors and lower number of revisions of biological material. Among the patients who received molecular targeted therapy, the overall median survival in the groups was 58 weeks as compared to the 35 weeks in the group of patients without molecular targeted therapy (р=0.097). In three patients, extraordinary response was noted.

Conclusion. The findings show clinical relevance of comprehensive genomic profiling in personalized treatment of solid tumors. The obtained data emphasize the need for careful selection of patients for comprehensive genomic profiling to improve its efficiency and availability.